Breastfeeding an infant exposed to Human Immunodeficiency Virus (HIV) carries the risk of HIV acquisition whilst not breastfeeding poses a higher risk of death from malnutrition, diarrhea, and pneumonia. In Uganda, mothers living with HIV are encouraged to discontinue breastfeeding at 12 months but data are limited. We examined the frequency and factors associated with cessation of breastfeeding at 1 year among mothers living with HIV at Ndejje Health Center IV, a large peri-urban health facility in Uganda. This retrospective cohort study involved all mothers living with HIV and enrolled in HIV care for ≥12 months between June 2014 and June 2018. We abstracted data from registers, held focus group discussions with mothers living with HIV and key informant interviews with healthcare providers. Cessation of breastfeeding was defined as the proportion of mothers living with HIV who had discontinued breastfeeding at 1 year. We summarized quantitative data descriptively, tested differences in outcome using Chi-square and t - tests, and established independently associated factors using modified Poisson regression analysis at 5% statistical significance level. We thematically analyzed qualitative data to enrich and triangulate the quantitative results. Of 235 participants, 150 (63.8%) had ceased breastfeeding at 1 year and this was independently associated with the infant being male (Adjusted Risk Ratio [aRR] 1.25, 95% confidence interval [CI] 1.04, 1.50), the mother being multiparous (aRR 1.26, 95% CI 1.04–1.53), and the initiation of breastfeeding being on the same-day as birth (aRR 0.06, 95% CI 0.01–0.41). The reasons for ceasing breastfeeding included male infants over breastfeed than females, maternal literacy and knowledge adequacy about breastfeeding, support and reminders from the partner, and boys can bite once they get teeth. Suboptimal proportion of infants were ceased from breastfeeding at 1 year and this might increase the risk of mother to child transmission of HIV. Cessation of breastfeeding was more likely among male infants and multiparous mothers but less likely when breastfeeding was initiated on the same-day as birth. Interventions to enhance cessation of breastfeeding should target none multiparous mothers and those with female infants.

中文翻译：

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乌干达 Ndejje 卫生中心在消除 HIV 母婴传播时代的停止母乳喂养和相关因素：一项回顾性队列研究。

母乳喂养暴露于人类免疫缺陷病毒 (HIV) 的婴儿有感染 HIV 的风险，而不母乳喂养的婴儿因营养不良、腹泻和肺炎而死亡的风险更高。在乌干达，鼓励感染艾滋病毒的母亲在 12 个月时停止母乳喂养，但数据有限。我们在 Ndejje 医疗中心 IV 检测了感染 HIV 的母亲在 1 岁时停止母乳喂养的频率和相关因素，该中心是乌干达的一个大型城郊医疗机构。这项回顾性队列研究涉及所有感染艾滋病毒并在 2014 年 6 月至 2018 年 6 月期间参加艾滋病毒护理≥12 个月的母亲。我们从登记册中提取数据，与感染艾滋病毒的母亲举行焦点小组讨论，并与医疗保健提供者进行关键知情人访谈。停止母乳喂养的定义是感染 HIV 的母亲在 1 岁时停止母乳喂养的比例。我们描述性地总结了定量数据，使用卡方和 t 检验测试了结果的差异，并使用改进的泊松回归分析在 5% 的统计显着性水平上建立了独立的相关因素。我们对定性数据进行了专题分析，以丰富和三角化定量结果。在 235 名参与者中，150 名 (63.8%) 在 1 岁时停止了母乳喂养，这与婴儿为男性独立相关（调整风险比 [aRR] 1.25，95% 置信区间 [CI] 1.04, 1.50），母亲为经产妇（aRR 1.26，95% CI 1.04–1.53），以及在出生当天开始母乳喂养（aRR 0.06，95% CI 0.01–0.41）。停止母乳喂养的原因包括男婴多于女婴、母亲对母乳喂养的识字和知识充足、伴侣的支持和提醒，以及男孩一旦长牙就会咬人。在 1 岁时停止母乳喂养的婴儿比例不理想，这可能会增加母婴传播 HIV 的风险。男婴和多产母亲更可能停止母乳喂养，但在出生当天开始母乳喂养的可能性较小。促进停止母乳喂养的干预措施应针对非经产母亲和有女婴的母亲。在 1 岁时停止母乳喂养的婴儿比例不理想，这可能会增加母婴传播 HIV 的风险。男婴和多产母亲更可能停止母乳喂养，但在出生当天开始母乳喂养的可能性较小。促进停止母乳喂养的干预措施应针对非经产母亲和有女婴的母亲。在 1 岁时停止母乳喂养的婴儿比例不理想，这可能会增加母婴传播 HIV 的风险。男婴和多产母亲更可能停止母乳喂养，但在出生当天开始母乳喂养的可能性较小。促进停止母乳喂养的干预措施应针对非经产母亲和有女婴的母亲。